Providers

Frequently Asked Questions

Serious emotional disturbance (SED) is a legal term that is defined in Idaho Code, 16-2403(13) and refers to people who have a mental, behavioral or emotional issue that limits their ability to participate in family, school, or community activities.

From the code:

"Serious emotional disturbance" means an emotional or behavioral disorder, or a neuropsychiatric condition which results in a serious disability, and which requires sustained treatment interventions, and causes the child’s functioning to be impaired in thought, perception, affect or behavior. A disorder shall be considered to
"result in a serious disability" if it causes substantial impairment of functioning in family, school or community…”

A person is identified as having SED if they have both a DSM diagnosis and a
functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

The Youth Empowerment Services Project (YES) has been authorized by the Department of Health & Welfare (DHW) as part of the Jeff D. Settlement Agreement resulting from the Jeff D. Class Action lawsuit.

The State of Idaho is in the process of developing a new children’s mental health system of care called YES – Youth Empowerment Services. It will provide a new way for families to find the mental health help they need for their children and youth. It will be strengths-based and family-centered, and it will incorporate a team approach that focuses on providing individualized care for children.

Class Members are Idaho residents with a serious emotional disturbance (SED) who are under the age of eighteen (18), have a diagnosable mental health condition based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) and have a substantial functional impairment. Such children, youth and their families are entitled to the services/supports listed in the Agreement.

Serious Emotional Disturbance (SED) is a mental, behavioral or emotional disorder that causes functional impairment that limits the child’s functioning in family, school, or community activities. This impairment interferes with how the child needs to grow and change on the path to adulthood including the ability to achieve or maintain age-appropriate social, behavioral, cognitive, or communication skills.

There will be new services as well as improvements made to existing services. The Appendix C of the Agreement lists multiple services and supports that will be included in the continuum of care. Most of these will become Medicaid benefits and some will be offered through the Division of Behavioral Health.

The services and supports have been chosen to provide a home and community-based treatment approach in the least restrictive setting. The services/supports will provide a full continuum of care available to the family based on the child's strengths/needs. The child and family team provides support to access services based on medical necessity requirements.

Some families may experience a change in the treatment plan with the addition of new services when services are applicable to their child’s needs and medical necessity is met. Some families may not see any changes in the treatment plan if their child has no need for changes. All families will experience a major change in the assessment process and the system of care because the state is adopting a new treatment philosophy. The new philosophy is referred to as the Principles of Care in Appendix B of the Agreement. This philosophy requires the individualized treatment plan to be based on the child’s strengths and needs. It relies on the Child & Family Team (CFT) that focuses on input from the family and the child (as the child/youth is able to participate).

As a parent you may obtain a new assessment for your child to determine if your child is a Class Member or if your child needs basic mental health services. The new assessment process includes a measure of your child’s strengths and needs. Children who are Class Members and their families will be able to access the services/supports available under the Agreement that are medically necessary and are delivered in the least restrictive environment. Children who are not Class Members will have access to an array of basic mental health services designed to prevent your child from needing more intense services.
Class Members and their families will be able to be active participants in the creation of their own Child & Family Team (treatment team) and in choosing services/supports that fit their needs that are to be included the treatment plan. No matter whether a child enters the system through corrections, school or other healthcare systems that child will experience a coordinated and holistic approach to their community-based mental health treatment needs.
DHW will continue to solicit input from families and youth regarding the development of the children’s mental health system of care so that once it is in place it meets the needs of the various communities across Idaho.

The state is creating multiple pathways for accessing a children’s mental health assessment. There will be a Checklist tool that anyone can use to help determine if a child may benefit from a full mental health assessment. A Screening tool will also be available for various types of professionals who are already working with a child to help them determine if they should refer the child for a full mental health assessment. Families may also request a full mental health assessment without first going through the Checklist or the Screening. The assessment process will be improved by use of a tool, CANS (Child and Adolescent Strengths and Needs), that captures the child’s strengths as well as the child’s needs and the needs of the caretakers.

Following the assessment process the family will be given the opportunity to establish their Child & Family Team with any of the people in their lives who support them and their child as well as the professionals and clinical service providers who are working with the child. The Class Member and the family are the most important voices in the treatment planning process. The treatment plan is built directly from the results of the CANS. The family is the main driver of the treatment plan.

Children and their families interested in obtaining mental health services will notice these changes:

· the assessment process with the use of a new tool, the CANS, for measuring strengths and needs,

· treatment planning will use a Child & Family Team (CFT) approach that allows the family to drive the creation of the plan,

· the choice in services which is being expanded in a phased approach across 4 years, and

· the CFT approach in the review process for noting the changes that have occurred in the child’s behavior and developing plans to address such changes.

The services and supports will be rolled out in phases between 2018 and 2020. Periodically, the state will be hosting information and training sessions about the new system of care and various topics pertaining to SED (serious emotional disturbance). Printed material describing the system of care and how it operates will be available to parents and youth throughout the life of the Project as services are added or modified.

Before determining all the features of the new system of care, the state intends to continue to solicit input from parents, youth who use the system, and providers so that the system reflects the needs of communities across Idaho.

Significant education and training must be made available prior to the roll-out of any new or modified service. Parents, youth, and the providers who serve them, need to have an understanding of how the new system works, what the definitions of the services/supports are, what the purpose of the services/supports are intended to be, how to access
the services/supports, what to do if you have any concerns or complaints about the system, and how to get involved in the development of the new system.

This work will continue through 2020 as services/supports are implemented across the state.

The new system of care represents a significant change in Idaho’s mental health service delivery model for children. Currently the various child-serving agencies work fairly independently to serve children. In the new system of care the child-serving agencies will collaborate to make sure that children who have severe emotional disturbance (SED) will be identified as early as possible and will be routed to the pathway for assessment and referral to services from any starting point (e.g. doctor, school, police).

Youth from around the state worked on creating a logo for the new system of care. The result is, “Youth Empowerment Services” (YES): Empowering the mental wellness of children, youth and their families.” They chose the Idaho Mountain Bluebird as the symbol. This website will continue to evolve as the project continues.

Parents should work with their child’s primary care provider and mental health provider to determine their child’s treatment needs. When a child has medical necessity for a service, as determined by these healthcare professionals, and that service is not available in the Medicaid State Plan, the parent should work with these professionals to make a formal request for such services through the Early Prevention Screening Diagnostics and Treatment (EPSDT) process. Building a network of providers who can meet children’s and their families’ mental health treatment needs is of major importance to the success of the Project and is a short- and long-term goal.

The Project will end when all the criteria for completing the work is met. This is described as “Exit Criteria” in the Settlement Agreement. The timeline of the Project is four (4) years of implementation followed by three (3) years of monitoring for sustainability.